The role of EDTA in provoking allergic reactions to subcutaneous infusion of apomorphine in patients with Parkinson's disease: a histologic study.
One of the formulations of apomorphine, used in clinical practice, contains sodium edetate (EDTA). EDTA is a chelator which indirectly prevents oxidation of apomorphine. A clinical and histologic study in four patients revealed that apomorphine with EDTA caused severe subcutaneous nodules, histologically characterized by an inflammatory infiltrate with a large amount of eosinophils, indicating a cell-mediated allergic reaction. After withdrawal of EDTA, this allergic component completely disappeared, which was accompanied clinically by less extensive nodule formation with a softer consistency. It is therefore recommended that EDTA be excluded from apomorphine formulations.
van Laar
T
T
Department of Neurology, University Hospital Leiden.
van Hilten
B
B
Neef
C
C
Rutgers
A W
AW
Pavel
S
S
Bruijn
J A
JA
D000009:Abdominal Muscles / Q000473:pathology*; D000978:Antiparkinson Agents / Q000009:adverse effects*; D001058:Apomorphine / Q000009:adverse effects*; D002614:Chelating Agents / Q000009:adverse effects*; D004338:Drug Combinations; D003875:Drug Eruptions / Q000473:pathology*; D004492:Edetic Acid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced / Q000473:pathology
D000978:Antiparkinson Agents; D002614:Chelating Agents; D004338:Drug Combinations; D004492:Edetic Acid; D001058:Apomorphine